What Is Psychodynamic Therapy — And Why Haven’t You Heard of It?
I find myself wishing I could come through the screen and ask you, “What do you know about Psychodynamic Therapy? What have you heard? Where did you hear it?”
I imagine that you might answer in a few ways. You might say you have no idea what I’m talking about, or you might say that you’ve heard that psychoanalysis is outdated and elitist. If that’s true, I’m even more appreciative that you’re here!
I deeply believe in the benefits of Psychoanalytic and Psychodynamic therapies. I get to see the results every day in my office. I get to witness people:
Liking themselves more
Feeling more creative
Making choices with confidence
Leaning into closeness with their loved ones
Releasing decades of pain they couldn't previous articulate
Trusting their inner voice
Finding peace with all parts of who they are
Believing in their own autonomy
Expanding their ability to feel deeply
It can feel like magic because when it works, it really works. Psychodynamic care is so rewarding as a practitioner because it isn't just about symptom relief – it's about expansion.
I think this is what most of us want when we go to therapy. We might not know how to say it or what to look for, but I think intuitively we're seeking help relating to ourselves and the world around us differently. Maybe we don't know what that means, but we know we want something different.
Research back this up. An organization called Psychotherapy Action Network found:
In our nationwide quantitative studies, in 2021 and 2023, 90% said they prefer a “Therapy that may take longer because it helps you manage your symptoms and also addresses the root cause of the problem,” while only 10% want a “Therapy that takes fewer sessions and helps you manage your symptoms, but doesn’t necessarily address the root cause of the problem.”
The study showed most people have no idea what Psychodynamic Therapy means. Even worse, the study found that most people have incredibly negative associations with Psychoanalysis.
I hope to help change this. I hope to take some of these big, abstract concepts and metabolize them into useful, digestible pieces of information.
Let's get into it. Let's think about what Psychodynamic/Psychoanalytic care is, why it's so unknown, and why it matters.
What is Psychodynamic Therapy?
Psychodynamic Therapy is a term used to describe a type of talk therapy that is based on the following key beliefs:
The human mind is not only our conscious thoughts and feelings, but also has an “unconscious.” This is different from “pre-conscious” or “subconscious,” which imply we have some awareness of these thoughts or feelings. The unconscious is exactly as it sounds – totally outside of our awareness. For example, you might not have any idea that your feelings about your finances are connected to the way you experienced a parent’s love as unreliable and inconsistent.
We repeat unconscious patterns so long as they are outside of our awareness.
Much of the unconscious is shaped by our development, i.e. childhood experiences and first relationships.
We gain awareness of the unconscious through the use of free associations (saying whatever comes to mind), understanding our development, and through the use of the therapeutic relationship.
Psychodynamic therapy is a field made up of over 100 years of development of techniques, theories, and practice. It’s called a practice because it’s a developing, lively way of thinking and working. It’s not the type of therapy that follows a step-by-step instruction manual or a singular formula. Every treatment is unique based on the several factors for both patient and therapist: personalities, timing in their lives and education, and the always evolving dynamics of the therapeutic relationship. No two therapists are exactly alike, and no two treatments are exactly alike.
How is it different from Psychoanalysis?
Psychodynamic therapy comes from Psychoanalytic Theory and shares the same key tenets, theoretical framework, and many of the same techniques. This can get very confusing because sometimes these words are used interchangeably. Psychoanalysis came first (think Freud), and its theories and practices have been adapted to be more widely accessible through the use of Psychodynamic therapy.
While Psychoanalysis uses 4-5 sessions per week, typically using the analytic couch, Psychodynamic therapy is typically 1-3 sessions per week with the patient sitting upright facing the therapist.
As you can imagine, the process of becoming a Psychodynamic therapist is also less arduous and less tightly regulated than that of becoming a Psychoanalyst. There are very specific criteria that must be met for someone to call themselves an analyst. I am not an analyst, but I have several years of advanced training in Psychodynamic Therapy – that uses Psychoanalytic theory. It’s no wonder that this is confusing to anyone not completely immersed in this world!
In a deeper sense, the differences between the two are up for debate. In my training program, we have an entire class dedicated to the differences between the two. It’s most important to know that there are significant technical and theoretical differences, mostly boiling down to the intensity of the treatment. Psychoanalysis is generally more intensive.
Why don’t more people know about it?
Social media platforms have helped a much larger audience learn about therapy and feel less shame for seeking therapy. But there aren’t many psychoanalysts on these platforms. I have a few ideas about why this is; psychoanalysts are busy writing for each other, teaching, and may be more boundaried with their online presence than other types of therapists.
Psychoanalytic writing is typically only read by other psychoanalysts. Psychoanalysts share case material only under specific circumstances, such as changing names and identifying information and obtaining consent from a patient. But those types of papers are typically only read in a community of peers with shared language and shared understanding of context. This type of case material is presented for the purpose of furthering the field, of contributing to research and helping to improve the way practitioners provide care.
It isn’t ethical or helpful to publish this type of content on social media or blogs. There are also other ethical considerations to having an online presence and working in a psychodynamic way. For example, there is much care and consideration put into what we call the “frame” of the treatment: how often you’re meeting, where you’re meeting, how you communicate in between sessions, what a patient knows about you personally, etc. It’s important to consider how a social media presence or a blog post could impact the treatment. Unlike other types of therapies, psychodynamic therapists are concerned with how it changes the treatment both in ways that are conscious (known) to the patient and ways that any change to the frame unconsciously impact the treatment.
Why is it important to speak publicly about Psychodynamic Therapy?
Psychodynamic therapy is the place to be curious, messy, and open to expansion. As we struggle with collective confusion, rage, and attempts at freedom, we need a place to sort through the knowns and unknowns of ourselves and our environment.
The idea that psychoanalytically-informed therapy is individualistic doesn’t capture the depth of what it can offer. I don’t believe we can make collective change without understanding ourselves more deeply. For example, we can practice coping skills to deal with anger and manage difficult emotions. But it’s just as important to understand what we’re really angry about. The more we know about our own aggression, the better we can make use of it. We actually can’t get rid of aggression, but we can work with it, understand it, and put it to work.
A collective full of people who know themselves, like themselves, and trust themselves is a powerful group. If you’re interested in hearing more about these ideas, I recommend the book A People’s History of Psychoanalysis by Daniel José Gaztambide.
I am well aware of the stereotype that Psychoanalysis is only for people with privilege. I won’t deny that it can be financially burdensome to be in treatment. Just like with other types of therapies, there are multiple ways that people can access this type of treatment, such as insurance benefits, out of network reimbursements, and clinics that receive grant funding. The issues of economic accessibility have more to do with systemic healthcare issues than with any one type of therapy.
I resent that this stereotype can make it appear as if only those with privileged identities can benefit from depth-oriented care. The insularity of psychoanalytic circles only perpetuates this myth. Many psychoanalytic practitioners rely on word of mouth referrals only. The problem is that this means you have to know someone who knows someone to get connected to treatment. I want to share more openly about this work because it’s aligned with my value of accessibility. It isn’t accessible care if no one knows that it exists or how it could help them. It isn’t accessible if you have to know someone personally who can point you in the right direction. It becomes more accessible when you can hear about it online.
Where can I find a therapist like this?
You can find a Psychoanalyst on directories like APSA, or MPS in Michigan. As I mentioned earlier, not every therapist with advanced training in this type of work is a Psychoanalyst. For this reason, it’s important to have familiarity with the term Psychodynamic to be able to look on other platforms like Google, Therapy Den, Inclusive Therapists, or Psychology Today.
If you live in Michigan or Pennsylvania and are interested in working with me, you can email me directly at amalia@amitydetroitcounseling.com or by submitting this form.